Gastrinoma

Synonyms in a broader sense

Zollinger-Ellison Syndrome
English: gastrinoma

definition

At the Gastrinoma (Zollinger-Ellison Syndrome) it is a tumor the gastrointestinal tract, which contains large amounts of Hormone gastrin produced. This hormone is a Messenger substance, which also occurs in the body of healthy people and after its release the stomach encourages Digestive enzymes and Stomach acid to build. This makes sense in healthy people, since gastrin is only controlled in response to certain stimuli, for example after eating, is released and thus helps to process ingested food. On the other hand, gastrin is used in people who have gastrinoma very uncontrolled and more educated. As a result, there is also a strong increase in gastric acid formation, which is ultimately responsible for the development of various complaints, as well as that Gastrinoma is.

frequency

Gastrinomas occur very rarely, one goes away 5 to 10 cases per million People and per year out. Mostly the age group is the 30-50 year olds affected, the disease occasionally occurs in early childhood.

Gastrinomas occur in men twice as often as with women before.

localization

The biggest part (about 80%) all Gastrinomas (Zollinger-Ellison Syndrome) is located in the pancreas. One speaks here of one "Ectopic" Localization, as in healthy adults normally no gastrin-producing G cells occur in the pancreas. In the child, however, the presence of G cells in the pancreas is normal.

Also kick Gastrinomas in the stomach and in Divide the small intestine, namely the Duodenum and the Jejunum, on.

Symptoms

Through the increased production of the hormone gastrin there is primarily one increased synthesis of gastric acid.

Gastrin works directly on certain cells of the stomach, the Parietal cellsthat are stimulated to form hydrochloric acid.

The increased hydrochloric acid level can result in the Stomach and / or intestinal wall is attacked and yourself Ulcers (med .: Ulceration), i.e. deep defects in the mucous membrane, which cause pain.

Kick the Pain directly while eating on, it is mostly a Gastric ulcer, kick the However, pain occurs during the night or on an empty stomach and subside while eating, it is more like a Duodenal ulcer.

In addition to the pain associated with gastrinoma, an ulcer-related patient may also experience an ulcer-related pain Bloating, Inappetence, nausea and Vomit occur.

Due to the increased production of gastric acid and the associated damage to the intestinal wall, around a third of those affected also have ulcers as well as ulcers Diarrhea, so Diarrhea on.

This is due to the fact that the damaged intestinal wall can no longer adequately absorb components of the food, so the food is excreted more or less unchanged together with the fluid that has been absorbed.

Besides the Damage to the intestinal wall Another phenomenon plays a role in the development of diarrhea:

Normally, the food components in the intestine are broken down by certain enzymes from the stomach and pancreas and thus made usable increased acid levels however, the structure of the enzymes is changed (denatured) and so damaged that they can no longer perform their function. Fats and carbohydrates thus remain unchanged in the intestine and could not be absorbed even if the intestinal wall is intact.

Complications

Typical Complications a gastrinoma (Zollinger-Ellison syndrome) arise mainly in connection with the ulcers.

When a Ulcer of the stomach or intestinal wall Penetrating very deeply, it is possible that blood vessels are attacked and cause it to Bleeding from the digestive tract comes, these can remain very small and unnoticed, but they can also take on larger dimensions.

In addition, an ulcer can damage the digestive system wall enough to cause it to become one Breakthrough of the organ concerned comes. A breakthrough often leads to one Peritonitis and must be treated immediately.